So it's 2253. Just did a final rounding check on my patients. They're all comfy in bed, falling asleep. Came back to the computer to make sure I'd finished all my charting. I notice on the monitor that one of my patients' pacemaker is acting very strangely. He'd been tachy in the 120s all day (each QRS with a pacing spike before it) but this time each QRS had two pacing spikes. Having never seen that before, I decided to call cross-cover and let them know. He'd had the battery replaced recently, and I figured any info on it would be helpful.
Two minutes later I get a text from the monitor techs. "rm 55 leads off. thx"
Immediately I get a sinking feeling. Rm 55 is a 90/f who fell yesterday and broke her hip. She has Alzheimer;s, and is confused easily. When asked, she is oriented to person and place. In an odd way, though, it's like her answers are recited and not understood.
"Do you know where you are right now?"
"Big Shiny New Hospital"
But she does not know what it means to be at the Big Shiny New Hospital and she can't remember why she's here.
So I head on down the hallway with the sneaking suspicion that she pulled all her wires.
Why can't I ever be wrong?
Not only has she pulled her tele, she is naked except for her SCDs and a smile, and her two IVs are sitting on the bedside table, along with some kleenex that was obviously used to stop the resultant bleeding.
At that moment I get a call back from cross-cover, who tells me to do an EKG on Mr CrazyPacer. Standing outside a naked woman's room.
I get off the phone as quickly as humanly possible and attend to Ms Sundowner. Still A&Ox2, and pleasant as can be. As she had all day, she would respond to any statement with "Whassat?" until it was repeated several times. I tried to explain, yet again, that I was her nurse and that I would help her. Happened to see my watch. 2257. There's no way I can clear this up in 3 minutes, so I call my Resource.
She comes in and takes over so I can give report to the poor girl who is taking over for me.
Report is given in record time, with much sighing and eye-rolling (understandably. I love you S! *grin*) from my replacement. Since we've finished quickly enough, I tell her I'll take care of Mr CrazyPacer's EKG.
It's 2315 and I get into the room and start up the machine, and I get a call from the Ass.Man. who is demanding to know why Ms Sundowner is getting a sitter and wondering what medications I could have given her instead and asking why I am not rounding more frequently on a patient that I know will be sundowning because she has a history of dementia and what isn't she getting something around the clock for her dementia and I nearly yelled at him to STFU.
I told him that I went by her room about twice an hour and she was sleeping the whole shift. She had no PRN anti-crazy meds and nothing around the clock. The only thing she was taking for Alzheimer's was Aricept. He then starts badgering me about what the MD said when I called (but I hadn't gotten a chance to call) so then I got questioned on why I didn't call. I told him that I knew nothing of the sitter because I asked the Resource to take over so I could give report, and that anything that happened between then and now was something she initiated. I told him I was trying to do an EKG and got off the phone as quickly as possible.
I apologized to Mr CrazyPacer (who was awesome btw) and did the EKG as best I could. The machine decided to hate me and I forgot which button printed out the kind of strip the MD wanted. Eventually got it and then got the hell outta Dodge.
The last thing I wanted was to run into the Ass.Man. on my way out.
I did the best I could, and all I got was him taking out frustrations on me at end of shift. AAARRRGHHH!